1. Simonetta Scalvini Fondazione Salvatore Maugeri, Telemedicine Service, Lumezzane (BS), Italy Clinical Results Bruxelles, 16tn June 2011

2. 16th June 2011 2 Baseline characteristics of patients TELEMACO (2007-2010) NRS (2006 – 2009) No of patients Age, years (mean ± SD) 130 69 ± 13 802 71 ± 11 Female (%)33 (25%)226 (28%) Onset of symptoms < 6 months (% patients) Onset of symptoms > 6 months (% patients) 81 (62%) 48 (37%) 292 (36%) 507 (63%) NYHA Class II NYHA Class III-IV 17 (13%) 113 (82%) 0 (0%) 802 (100%) Patients with 0 – 1 co-morbidity (% patients) Patients with 2 co-morbidities 104 (80%) 26 (20%) 408 (63%) 294 (37%) Patients with 2 admissions in 6 months before (% patients) 40 (31%) 208 (26%) Home Base Telemanagment in Chronic Heart failure (CHF)

3. Home Base Telemanagment in CHF: clinical results 3 Telephone calls and actions taken TELEMACO (2007-2010) NRS (2006 – 2009) for weekfor HBT periodfor weekfor HBTperiod No of scheduled calls/patient1.19830.91.39323.1 No of unscheduled calls/patient0.0841.70.0941.4 No of ECG transmissions/patient1.08328.21.36322.3 No of changes in therapy/patient0.1994.60.2113.7 No of ED suggested0.0140.20.0300.3 Clinical events TELEMACO (2007-2010) NRS (2006 – 2009) Cardiovascular (including HF) readmission0.27 ± 0.620.34 ±0.63 Non Cardiovascular readmission0.15 ± 0.450.15 ± 0.44 16th June 2011Outcome T0T1p Ejection Fraction (%)31.8 ± 1140.2 ± 11.30.000 Walking Test351 ± 127363 ± 1660.052 Minnesota QoL42.5 ± 20.023.5 ± 18.60.000

4. 16th June 2011 4 Baseline characteristics of patients TELEMACO (2007-2010) No of patients Age, years (mean ± SD) 393 72 ± 8 Female (%)84 (21%) Diagnosis58 % in clinical stable conditions Therapy 46 % in oxygen-therapy for 24H 27 % in oxygen-therapy only over night or under-stress Functional exams55 % with FEV 1 < 50% Smoke history - Smokers - No smokers - - Ex smokers 62 (37%) 39 (16%) 282 (10%) BMI: - Under weight - Normal weight - Over weight - Obese 15 (4%) 121 (31%) 142 (36%) 104 (26%) Home Base Telemanagment in Chronic Obstructive Pulmonary Disease (COPD) severe or very severe COPD (III - IV GOLD class )

5. 5 16th June 2011 Home Base Telemanagment in COPD: results Telephone calls and actions taken TELEMACO (2007-2010) for weekfor HBT period No of scheduled calls/patient1.07 ± 0.7425.6 ± 7.6 No of unscheduled calls/patient0.05 ±0.260.7 ±1.2 No of SpO2 transmissions/patient1.0 ± 0.7723.6 ± 8.2 No of changes in therapy/patient0.1102.58 No of ED suggested0.0170.074 Clinical events TELEMACO (2007-2010) Pulmonary readmission (per patient for HBT period)70 (0.18) Non Pulmonary readmission (per patient for HBT period)47 (0.12) Outcome Coupled value T1-T0p San George Questionnaire: - Symptoms - Activity - Impact 323 322 323 -2.384 -2.736 -4.016 -2.984 0.017 0.006 0.000 0.003

6. Second opinion for GPs: Results Total No of teleconsultation TELEMACO (2007-2010) At patients home489 (10%) Patients follow up2828 (58%) Patients new symptoms1890 (39%) Patients age (y) Sex (male) 62 ± 20 1935 (45%)

7. 7 Second opinion for GPs: results After the second opinion, GPs change their decisions in the 87% of the patients

8. Second opinion on cranium TC scan: results Total No of teleconsultation TELEMACO (2009-2010) Stroke Cranial Trauma 68 79 Patients mean age (y) Male 67 ±17 75 (51%) To send in other hospital (before teleconsultation) After teleconsultation 78 (53%) 19 (18%)